07D0967514 CLIA NUMBER - FAIRFIELD SURGERY CENTER LLC

Laboratory Demographics

CLIA Number: 07D0967514

Facility Name: FAIRFIELD SURGERY CENTER LLC

Facility Address:
305 BLACK ROCK TURNPIKE
FAIRFIELD, CT
ZIP 06430
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Facility Phone Number: 203 337-2660

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1881804508

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	07D0967514
LAB Type	Ambulatory Surgery Center
Facility Name	FAIRFIELD SURGERY CENTER LLC
Street	305 BLACK ROCK TURNPIKE
City	FAIRFIELD
State	CT
ZIP	06430
Phone	203 337-2660
CertificateType	4
CertificateEffectiveDate	11/16/2023
CertificateExpirationDate	11/15/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024